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With Persistence, Recovering from Depression

October 22, 2013

The Addlestones

Staying the course to get the right treatments, and having lots of support, lets this man enjoy his family again

From The Quarterly, Fall 2013

Twenty years ago, Steven Addlestone, then a recent graduate of Vanderbilt University Law School, had just begun his practice with a major Atlanta law firm and was newly engaged to his law school sweetheart. It was a time that should have been one of the happiest of his life. But seemingly out of the blue, he spiraled into a major depression that lasted four months. As his moods yo-yoed beyond his control, Steven went from one treatment to another without much success. It would be 12 years before his doctor was able to stabilize his symptoms.

What sustained him during those years and made it possible for him to function, if with difficulty, was the support he received from his family and colleagues who, he says, “understood what was going on and were willing to work with me.” Now, at 44, having had no major relapses for the past seven years and feeling “really well,” Steven holds a post as senior counsel at a Fortune 500 company in Tennessee, where he lives with his wife, Claire, and their teenage son and daughter. “Most importantly,” he says, “I’m able to enjoy being with the family who supported me so much during the hard times.”

Recently, hoping to help others who may not have adequate support, Steven signed on as a peer counselor in a program for members of his profession who are experiencing mental or emotional distress. “There’s still a lot of stigma attached to mental illness,” he says, “and often people don’t seek treatment because they’re embarrassed at having a ‘weakness’ they don’t want to admit.”

Steven was particularly fortunate that while still in Atlanta, when his worst crisis hit and his thoughts turned suicidal, he was treated at Emory University Hospital. There his journey to recovery finally began, jump-started by electroconvulsive therapy (ECT). “I responded well, and I have no doubt it saved my life,” he says.

In ECT, electrical currents are passed through the brain to trigger a brief seizure, which often works to ease the symptoms of depression when antidepressant medications fail. Unlike the “shock treatments” of years ago, today’s ECT is painless and relatively free of side effects, but there can be some memory loss. In Steven’s case, the treatment was effective, if short-lived. He had to return for additional ECT every couple of weeks. By the time he reached 100 sessions, his doctors became a bit concerned. “Every time we tried to stretch out the time between treatments,” he says, “my depression recurred.”

The doctor who finally came up with a mix of medications that allowed him to stop ECT was a young psychiatrist named Paul Holtzheimer, M.D., M.S., Associate Professor of Psychiatry at the Geisel School of Medicine at Dartmouth. Dr. Holtzheimer is a former trainee of Helen S. Mayberg, M.D., Professor of Psychiatry, Neurology and Radiology at Emory University School of Medicine, three-time NARSAD Grantee and Foundation Scientific Council member. Dr. Mayberg is widely regarded for her innovative work with brain imaging to identify depression pathology in the brain and develop new treatments to more effectively treat resistant depression. Dr. Holtzheimer received a NARSAD Young Investigator Grant in 2007 while working with Dr. Mayberg at Emory to further studies on an area of the brain called the subcallosal cingulate (or “Brodmann Area 25”) that she identified as being involved in depression.

In addition to a combination of medications––the antidepressants fluoxetine (Prozac®) and buproprion (Wellbutrin®), the antipsychotic medication risperidone (Risperdal®), the anti-anxiety medication buspirone (BuSpar®) and the mood stabilizer valproic acid (Depacote®)―used to treat his depression, fluoxetine helps control Steven’s symptoms of obsessive-compulsive disorder (OCD), which he is also addressing through cognitive behavioral therapy, conducted via Skype with a therapist in Knoxville. The co-occurrence of more than one mental illness is not uncommon.

Steven now recognizes that he has had OCD symptoms since childhood, but, as he recounts with wry amusement, “I didn’t know then that setting my alarm clock 100 times before I went to bed was anything unusual.”

No one who has had experience with mental illness needs to be told that it’s a family affair. Claire Addlestone was an up-and-coming corporate attorney when she put her career on hold to take care of her husband during his darkest days and to shoulder the lion’s share of their children’s early rearing. Today, she practices a very different kind of law, as a guardian ad litem, a court-appointed legal representative for neglected and abused children. In that role, she sees daily the ravages that parental stress and mental illness can inflict on families who lack the knowledge or resources to obtain appropriate diagnoses and help.

The Addlestones’ support of the Brain & Behavior Research Foundation began for them with a very personal appreciation of the work of the NARSAD Grant-supported scientists at Emory.

“We think it [the research] is all so promising,” Steven says. “We marvel how far research and treatment have come just since I started having my problems. It’s really uplifting.”

Article comments

Thanks so much for candidly sharing your story! Thanks, too, for not buying into any sense of shame. Nobody deserves to feel ashamed due to an illness/health challenge.

There is HOPE!

It's important we dispel the myths and learn/teach truths concerning any/all forms, and all degrees, of brain disorders (including those we refer to as mental illnesses). Nobody is immune from these forms of health/life challenges anymore than any of us are immune from other forms of illness/health challenges in our lives.

We are all in this together! Let's keep sharing and learning from one another, with the common goal of mutual understanding and support, in an effort to conquer these challenging conditions as soon as possible. You have my admiration and my gratitude. May you always find inner peace, comfort and joy in your life. : )

Steven, you are so fortunate to have had the family support you've described, a well-qualified psychiatrist who was aggressive with your treatment early on, and to have found a cocktail of meds that work well for you. You've survived a lot, and I'm sure you've worked hard at it. Yours is an example of the success one can have in the fight against this illness.
I've struggled with increasingly severe episodes of depression for over twenty five years. Unlike you, my episodes were initially of mild to moderate severity, controlled by various meds. But the episodes became more frequent, more severe, and less well controlled by meds. My first hospitalization over eleven years ago was more traumatizing than healing; and I never really recovered from that. I struggled for the next four years to keep working, trying to regain some sense of normalcy in my life; but it was as if I was ever so slowly sinking in quicksand. I last worked seven years ago, and my life has been slowly unraveling since then. I was without health insurance and received only minimal treatment for several years; but that hardly seemed important, because the meds had ceased to work by then. I am one of those whose depression became treatment-resistant; I was unable to tolerate most of the meds that I was prescribed - and there were MANY - and the few that had worked in the past ceased to have any effect at all. I've been hospitalized multiple times in the past four years. I've undergone two courses of ECT, about a year apart, but that also proved completely ineffective. I've lost my home, many of the possessions I worked so hard to obtain, my ability to function, my sense of self - my soul. I don't feel human any more. I don't know how I continue to exist.
The one thing that may have promoted my healing and potential recovery more than all the meds and other treatments combined is the support of my family, but that has been virtually non-existent. My mother has never been able to "be around these depressed people"; and while she's claimed for years she doesn't feel that way about me because I'm her daughter, that's clearly not true. With each hospitalization she became more distressed, and less able to "deal with" me. There have been increasingly extended periods of time in the last two years when she is simply unable to talk to me. The rest of my immediate family try to "protect" her from me; they aren't so much distressed as they are uninterested, or too busy, or simply not convinced that depression can really be such a devastating illness. My elderly parents live with and are completely supported by one of my siblings and her husband, who are millionaires several times over. In their world, mental illness doesn't exist; it's something to be ignored and avoided, and with little exception that's what happens. While it's heart-wrenching enough to have no physical or emotional support from the people who profess that "family means everything", it absolutely tears my heart out to be separated from my parents in their final years. But it has been made very clear to me that there will be no form of help or support offered to me, and that contact with my parents - and with my sister & her husband - will be very limited because of my "condition".
I try to draw inspiration from the stories and experiences of people like you. I know in my heart that I'd be much better off with a loving, supportive family - love can be the most powerful medicine there is - even if I'll never be completely "well". But it's so hard to continue to fight when there's really nothing left to fight for - or to fight with.
You are so fortunate to have had good doctors, and effective treatment, and a loving, supportive family. There are too many of us who can't tell the same story you can - who doctors and medications and treatments and monumental efforts haven't helped. Still, it's good to have people like you share their stories of healing and hope, because there will be people who are inspired and helped by hearing from one who has had success in his fight against this illness. I wish you and your family the best, and thank you for sharing your story.

Yes, your story is a success story and I know you are thankful for your recovery. I have experienced 8 major depression episodes. It is difficult....I go to bed each night hoping that when I awaken I will feel joy.

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